Stress urinary incontinence is a well recognized female physical problem which manifests itself by uncontrolled urinary discharge during strenuous exercise or activity such as lifting, coughing or sneezing. The cause of the condition is anatomical and has been traced to a characteristic of the angle between the bladder and the urethra, known as the urethrovesical angle. Discussions of the condition and some devices for dealing with it appear in the following patents.
U.S. Pat. No. 3,554,184 Habib, PA1 U.S. Pat. No. 3,705,575 Edwards, PA1 U.S. Pat. No. 4,139,006 Corey.
It is normally possible to correct the urethrovesical angle surgically to eliminate the problem. However, urinary incontinence in a female can result from several causes, some of which have nothing to do with the urethrovesical angle. Thus, it is important for the attending physician to be able to determine that this anatomical characteristic is, in fact, the cause of the incontinence in a specific patient. It is also the case, with some patients, that surgery is not possible because of the age of the patient or because other illnesses indicate that surgery would not be desirable.
Various tests have been devised for proving that the urethrovesical angle is the condition responsible for a patient's incontinence. None of these are particularly successful, and some are rather complicated and expensive to perform. In one such test, called the Bonnie test, the urethrovesical angle is elevated by manual force applied through the vagina with the patient in a supine position. Unfortunately, this test is not always reliable because it is difficult, if not impossible, to elevate the urethrovesical angle without collapsing the urethra, thereby making the test inaccurate. Additionally, under the conditions for performing this test, it is not possible to duplicate some of the activities which cause stress incontinence in normal daily activities.